For Democrat Hala Ayala, Republican efforts to repeal the Affordable Care Act don’t just make her angry — they break her heart.

In her bid to unseat Del. Rich Anderson, R-51st District, she has often spoken about her time relying on Medicaid. Now the renewed push in Congress to roll back former President Barack Obama’s healthcare law has her urging lawmakers to listen to the stories of people who rely on the program.

Though she’s now in a position to run for political office in Prince William, Ayala vividly remembers being 24-years-old, working at a gas station along Old Bridge Road, when she discovered her unborn son was facing serious health problems. Her baby was facing “life-threatening” breathing problems, not to mention diabetes and acid reflux disease, but she didn’t have any health insurance through her job.

“Thank God we were covered under Medicaid,” Ayala said in a Sept. 19 interview. “Otherwise, he might not be here today.”

Accordingly, the very thought of GOP efforts to roll back the expansion of the Medicaid program under the ACA chokes her up. The latest Republican healthcare bill — championed by Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C. — would end the expansion by 2020, and while there’s no guarantee it will become law, Ayala is troubled all the same.

“It makes me sad, because it saved my son’s life,” Ayala said, between tears. “These are services and options and opportunities for people to live and thrive in our community and be healthy. And they’re able to live in our communities and be civically engaged or watch their child walk across the stage when they graduate. It’s a humanitarian impact. We’re going to do whatever it takes in Virginia to make sure it doesn’t happen.”

But Ayala is primarily focused on what sort of difference she can make in Richmond. Virginia is one of dozens of states with Republican legislatures that have declined to expand Medicaid under the ACA, something she’d love to change if she makes it to the General Assembly.

Former Congressman Tom Perriello is doing his best to help Ayala on that front. Though his bid for the Democratic nomination in the gubernatorial primary wasn’t successful, he’s since launched “Win Virginia,” a political action committee dedicated to helping Democratic House candidates like Ayala flip Republican seats.

“This is the first election where legislators are going to be held accountable for screwing over their neighbors,” Perriello said. “These are legislators that talk nice, but vote mean. They seem moderate when they show up at the Little League game, but, in fact, have been going to Richmond and pursuing a truly radical agenda that has hurt the middle class and the working poor in Virginia.”

Perriello and Ayala charge that Anderson certainly fits that bill. He’s repeatedly voted against Democratic Gov. Terry McAuliffe’s pushes to expand Medicaid, denying insurance access to as many as 12,000 people in Prince William alone.

“Where I live in Prince William County, my story is not an isolated incident,” Ayala said.

Anderson didn’t immediately respond to a request for comment, but Republican leaders in the House have frequently argued that expanding Medicaid would be unaffordable for Virginia taxpayers. In a 2014 floor speech, Anderson himself charged that federal funding for the expansion is “likely unsustainable.”

But Ayala argues the state is losing $73 million each year by refusing the expansion — under the ACA, the federal government would initially pay the entire cost of expanding coverage, then gradually shift 10 percent of the expense to the state.

Republicans also argue that the state should tread carefully on the issue, with so much uncertainty surrounding the ACA as Congress continues to mull its repeal. Yet Perriello is optimistic that the healthcare law will survive this latest push — Senate Republicans only have until Sept. 30 to pass a bill strictly along party lines, and Democrats seem unlikely to compromise on any rollback of the ACA — and he hopes another failure of repeal in Congress will convince Richmond Republicans to change their minds.

“Most of them, privately, know Medicaid expansion makes sense,” Perriello said. “Many of them say they want to get to ‘Yes,’ so maybe the survival of the ACA this week gives them the chance to make that excuse.”

Yet Perriello also believes that there’s no surer way to ensure an expansion of Medicaid in Virginia than fighting for the election of Democrats like Ayala this November.

“Republican leaders have had eight years to step out and show a little bit of moral courage of putting their communities ahead of a fear of primary, and they haven’t done it,” Perriello said. “A lot voters in places like Prince William who would normally only show up for presidential elections are realizing how much local elections matter.”